scholarly journals A Survey of Digital Rectal Examination Training in Canadian Medical Schools

2012 ◽  
Vol 26 (7) ◽  
pp. 441-444 ◽  
Author(s):  
Alysha Nensi ◽  
Nilesh Chande
Keyword(s):  
Clinical Training ◽  
Clinical Skills ◽  
Digital Rectal Examination ◽  
Medical Schools ◽  
Teaching Session ◽  
Rectal Examination ◽  
Gynecological Disorders ◽  
Video Tutorials ◽  
English Speaking ◽  
Undergraduate Medicine

BACKGROUND: The digital rectal examination (DRE) is important for the diagnosis of a variety of gastrointestinal, urological and gynecological disorders. However, it appears that Canadian medical students may not be adequately taught nor provided the opportunity to practice their skills often enough. The present study was an analysis of the current practices in DRE teaching and evaluation in undergraduate medicine programs across Canada.METHODS: Clinical skills coordinators from the 14 English-speaking medical schools in Canada were invited to participate in the survey and to respond to questions regarding DRE teaching at their respective schools.RESULTS: Thirteen of the 14 schools (93%) responded to the survey. The DRE is taught in various ways: 69% of schools use anatomical rectal models, 62% use video tutorials and 62% involve physician instruction. Most schools (85%) offer one formal teaching session before clerkship. Generally, there is no formal DRE teaching session during clerkship. Preclerkship students in 62% of the schools perform ≤1 DRE during their training, and clinical skills coordinators in 85% of the schools expected that clerkship students perform ≤2. The training is evaluated in a variety of ways, with most schools (77%) only requiring mandatory attendance.DISCUSSION: Although a variety of techniques are used to teach and evaluate DRE training in Canadian medical schools, students are performing very few DREs before graduation. Medical schools should objectively evaluate proficiency to give meaningful feedback and improve competence in their students as well as provide more opportunities for students to obtain the necessary experience performing DREs during their clinical training.

scholarly journals Missing the mark: Current practices in teaching the male urogenital examination to Canadian undergraduate medical students

2016 ◽  
Vol 10 (7-8) ◽  
pp. 281
Author(s):  
Kristen McAlpine ◽  
Stephen Steele
Keyword(s):  
Medical Students ◽  
Clinical Training ◽  
Clinical Skills ◽  
Medical Schools ◽  
Clinical Settings ◽  
Undergraduate Medical Students ◽  
Canadian Medical School ◽  
Competency Based ◽  
English Speaking ◽  
And Training

<p><strong>Introduction:</strong> The urogenital physical examination is an important aspect of patient encounters in various clinical settings. Introductory clinical skills sessions are intended to provide support and alleviate students’ anxiety when learning this sensitive exam. The techniques each Canadian medical school uses to guide their students through the initial urogenital examination has not been previously reported.</p><p><strong>Methods:</strong> This study surveyed pre-clerkship clinical skills program directors at the main campus of English-speaking Canadian medical schools regarding the curriculum they use to teach the urogenital examination.</p><p><strong>Results:</strong> A response rate of 100% was achieved, providing information on resources and faculty available to students, as well as the manner in which students were evaluated. Surprisingly, over onethird of the Canadian medical schools surveyed failed to provide a setting in which students perform a urogenital examination on a patient in their pre-clinical years. Additionally, there was no formal evaluation of this skill set reported by almost 50% of Canadian medical schools prior to clinical training years.</p><p><strong>Conclusions:</strong> To ensure medical students are confident and accurate in performing a urogenital examination, it is vital they be provided the proper resources, teaching, and training. As we progress towards a competency-based curriculum, it is essential that increased focus be placed on patient encounters in undergraduate training. Further research to quantify students’ exposure to the urogenital examination during clinical years would be of interest. Without this commitment by Canadian medical schools, we are doing a disservice not only to the medical students, but also to our patient population.</p>

scholarly journals Impact of integrating objective structured clinical examination into academic student assessment: Large-scale experience in a French medical school

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245439
Author(s):  
Alexandre Matet ◽  
Ludovic Fournel ◽  
François Gaillard ◽  
Laurence Amar ◽  
Jean-Benoit Arlet ◽  
...  
Keyword(s):  
Medical School ◽  
Clinical Training ◽  
Large Scale ◽  
Clinical Skills ◽  
Student Assessment ◽  
Medical Schools ◽  
Interpersonal Behavior ◽  
Behavioral Skills ◽  
And Behavior ◽  
The Impact

Purpose Objective structured clinical examinations (OSCE) evaluate clinical reasoning, communication skills, and interpersonal behavior during medical education. In France, clinical training has long relied on bedside clinical practice in academic hospitals. The need for a simulated teaching environment has recently emerged, due to the increasing number of students admitted to medical schools, and the necessity of objectively evaluating practical skills. This study aimed at investigating the relationships between OSCE grades and current evaluation modalities. Methods Three-hundred seventy-nine 4th-year students of University-of-Paris Medical School participated to the first large-scale OSCE at this institution, consisting in three OSCE stations (OSCE#1–3). OSCE#1 and #2 focused on cardiovascular clinical skills and competence, whereas OSCE#3 focused on relational skills while providing explanations before planned cholecystectomy. We investigated correlations of OSCE grades with multiple choice (MCQ)-based written examinations and evaluations of clinical skills and behavior (during hospital traineeships); OSCE grade distribution; and the impact of integrating OSCE grades into the current evaluation in terms of student ranking. Results The competence-oriented OSCE#1 and OSCE#2 grades correlated only with MCQ grades (r = 0.19, P<0.001) or traineeship skill grades (r = 0.17, P = 0.001), respectively, and not with traineeship behavior grades (P>0.75). Conversely, the behavior-oriented OSCE#3 grades correlated with traineeship skill and behavior grades (r = 0.19, P<0.001, and r = 0.12, P = 0.032), but not with MCQ grades (P = 0.09). The dispersion of OSCE grades was wider than for MCQ examinations (P<0.001). When OSCE grades were integrated to the final fourth-year grade with an incremental 10%, 20% or 40% coefficient, an increasing proportion of the 379 students had a ranking variation by ±50 ranks (P<0.001). This ranking change mainly affected students among the mid-50% of ranking. Conclusion This large-scale French experience showed that OSCE designed to assess a combination of clinical competence and behavioral skills, increases the discriminatory capacity of current evaluations modalities in French medical schools.

Current Issues: Advanced Digital Technology for Supervising Graduate Clinicians

2010 ◽  
Vol 20 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Glenn Tellis ◽  
Lori Cimino ◽  
Jennifer Alberti
Keyword(s):  
Real Time ◽  
Digital Technology ◽  
Clinical Training ◽  
State Of The Art ◽  
Clinical Skills ◽  
Slow Motion ◽  
Video Capture ◽  
Microsoft Excel ◽  
Clinical Supervisors ◽  
Training And Supervision

Abstract The purpose of this article is to provide clinical supervisors with information pertaining to state-of-the-art clinic observation technology. We use a novel video-capture technology, the Landro Play Analyzer, to supervise clinical sessions as well as to train students to improve their clinical skills. We can observe four clinical sessions simultaneously from a central observation center. In addition, speech samples can be analyzed in real-time; saved on a CD, DVD, or flash/jump drive; viewed in slow motion; paused; and analyzed with Microsoft Excel. Procedures for applying the technology for clinical training and supervision will be discussed.

The Clinician Directed Hierarchy: A Clinical Training Tool

2008 ◽  
Vol 11 (2) ◽  
pp. 56-60 ◽  
Author(s):  
Jill K. Duthie
Keyword(s):  
Clinical Supervision ◽  
Clinical Training ◽  
Clinical Teaching ◽  
Clinical Skills ◽  
Clinical Settings ◽  
Specific Level ◽  
Problem Solving Skills ◽  
Training Tool ◽  
Target Behaviors ◽  
Intervention Process

Abstract Clinical supervisors in university based clinical settings are challenged by numerous tasks to promote the development of self-analysis and problem-solving skills of the clinical student (American Speech-Language-Hearing Association, ASHA, 1985). The Clinician Directed Hierarchy is a clinical training tool that assists the clinical teaching process by directing the student clinician’s focus to a specific level of intervention. At each of five levels of intervention, the clinician develops an understanding of the client’s speech/language target behaviors and matches clinical support accordingly. Additionally, principles and activities of generalization are highlighted for each intervention level. Preliminary findings suggest this is a useful training tool for university clinical settings. An essential goal of effective clinical supervision is the provision of support and guidance in the student clinician’s development of independent clinical skills (Larson, 2007). The student clinician is challenged with identifying client behaviors in the therapeutic process and learning to match his or her instructions, models, prompts, reinforcement, and use of stimuli appropriately according to the client’s needs. In addition, the student clinician must be aware of techniques in the intervention process that will promote generalization of new communication behaviors. Throughout the intervention process, clinicians are charged with identifying appropriate target behaviors, quantifying the progress of the client’s acquisition of the targets, and making adjustments within and between sessions as necessary. Central to the development of clinical skills is the feedback provided by the clinical supervisor (Brasseur, 1989; Moss, 2007). Particularly in the early stages of clinical skills development, the supervisor is challenged with addressing numerous aspects of clinical performance and awareness, while ensuring the client’s welfare (Moss). To address the management of clinician and client behaviors while developing an understanding of the clinical intervention process, the University of the Pacific has developed and begun to implement the Clinician Directed Hierarchy.

scholarly journals Web-based Medical Education During COVID-19 Lockdown: A Step Back or a Leap to the Future?

2021 ◽  
pp. 153473462110118
Author(s):  
Anna Eleftheriou ◽  
Aikaterini Rokou ◽  
Christos Argyriou ◽  
Nikolaos Papanas ◽  
George S. Georgiadis
Keyword(s):  
Medical Education ◽  
Clinical Training ◽  
Medical Training ◽  
Medical Schools ◽  
Web Based ◽  
Clinical Exposure ◽  
Virtual Teaching ◽  
Based Medicine ◽  
The Impact

The impact of coronavirus infectious disease (COVID-19) on medical education has been substantial. Medical students require considerable clinical exposure. However, due to the risk of COVID-19, the majority of medical schools globally have discontinued their normal activities. The strengths of virtual teaching now include a variety of web-based resources. New interactive forms of virtual teaching are being developed to enable students to interact with patients from their homes. Conversely, students have received decreased clinical training in certain medical and surgical specialities, which may, in turn, reduce their performance, confidence, and abilities as future physicians. We sought to analyze the effect of telemedicine on the quality of medical education in this new emerging era and highlight the benefits and drawbacks of web-based medical training in building up future physicians. The COVID-19 pandemic has posed an unparalleled challenge to medical schools, which are aiming to deliver quality education to students virtually, balancing between evidence-based and experience-based medicine.

scholarly journals Peer Mentoring as a Tool for Developing Soft Skills in Clinical Practice: A 3-Year Study

2021 ◽  
Vol 9 (5) ◽  
pp. 57
Author(s):  
Antonio M. Lluch ◽  
Clàudia Lluch ◽  
María Arregui ◽  
Esther Jiménez ◽  
Luis Giner-Tarrida
Keyword(s):  
Clinical Practice ◽  
Skill Acquisition ◽  
Clinical Training ◽  
Peer Mentoring ◽  
Clinical Skills ◽  
Technical Skills ◽  
Study Groups ◽  
Self Evaluation ◽  
Academic Knowledge ◽  
Post Hoc

Education currently focuses on improving academic knowledge and clinical skills, but it is also important for students to develop personal and interpersonal skills from the start of their clinical practice. The aim was to evaluate the effect of peer mentoring in third-year students and to gauge the evolution of non-technical skills (NTS) acquisition up to the fifth year. The study groups were selected between September 2015 and May 2018, based on the NTS training they had or had not received: (1) fifth-year students with no training (G1); (2) third-year students mentored in NTS (G2a); and (3) a small group of fifth-year students who became mentors (G2b). A total of 276 students who took part in this study were assessed using a 114-item self-evaluation questionnaire. Data were collected from seven surveys conducted between September 2015 and May 2018, and statistical analysis was performed using one-way ANOVA and Fisher’s post-hoc test. G2a improved their non-technical skill acquisition over three years of clinical training up to their fifth year. This group and G2b showed statistically significant differences compared to non-mentored students (G1). Peer mentoring at the beginning of clinical practice is a valid option for training students in non-technical skills.

scholarly journals Clinical diagnosis of prostate cancer using digital rectal examination and prostate-specific antigen tests: a systematic review and meta-analysis of sensitivity and specificity

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Nelson C. Okpua ◽  
Simon I. Okekpa ◽  
Stanley Njaka ◽  
Augusta N. Emeh
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Sensitivity And Specificity ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Antigen Test ◽  
Rectal Examination ◽  
Prostate Specific Antigen Test ◽  
Prostate Cancers ◽  
Antigen Tests

Abstract Background Being diagnosed with cancer, irrespective of type initiates a serious psychological concern. The increasing rate of detection of indolent prostate cancers is a source of worry to public health. Digital rectal examination and prostate-specific antigen tests are the commonly used prostate cancer screening tests. Understanding the diagnostic accuracies of these tests may provide clearer pictures of their characteristics and values in prostate cancer diagnosis. This review compared the sensitivities and specificities of digital rectal examination and prostate-specific antigen test in detection of clinically important prostate cancers using studies from wider population. Main body We conducted literature search in PubMed, Medline, Science Direct, Wiley Online, CINAHL, Scopus, AJOL and Google Scholar, using key words and Boolean operators. Studies comparing the sensitivity and specificity of digital rectal examination and prostate-specific antigen tests in men 40 years and above, using biopsy as reference standard were retrieved. Data were extracted and analysed using Review manager (RevMan 5.3) statistical software. The overall quality of the studies was good, and heterogeneity was observed across the studies. The result comparatively shows that prostate-specific antigen test has higher sensitivity (P < 0.00001, RR 0.74, CI 0.67–0.83) and specificity (P < 0.00001, RR 1.81, CI 1.54–2.12) in the detection of prostate cancers than digital rectal examination. Conclusion Prostate-specific antigen test has higher sensitivity and specificity in detecting prostate cancers from men of multiple ethnic origins. However, combination of prostate-specific antigen test and standardized digital rectal examination procedure, along with patients history, may improve the accuracy and minimize over-diagnoses of indolent prostate cancers.

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